WOMEN'S EXPERIENCES OF TRANSITIONING TO ENDOCRINE-BASED ORAL THERAPY

Purpose/Aims: The specific aims of this study are to: 1)Describe the transition to endocrine based oral therapy (EBOT) experience of women with estrogen receptor positive breast cancer. 2) Identify what women transitioning to EBOT describe as unmet needs requiring intervention to improve the transition experience. 3) Determine what women transitioning to EBOT describe as facilitating and hindering the transition experience over the first several months of treatment. Background: Eighty per cent of breast cancers in women over 45 years of age are estrogen receptor positive cancers (Glass, Lacey, Carreon, & Hoover, 2007). At the end of what is typically a yearlong, aggressive treatment period, these women are expected to initiate 5-10 more years of ongoing treatment with endocrine-based oral chemotherapy (EBOT). Evidence from clinical trials aimed at reducing recurrence and improving life expectancy suggests that women on EBOT experience many distressing symptoms (Fellowes, Fallowfield, & Saunders, & Houghton, 2001; Fallowfield, et al., 2004; Tchen, et al., 2003; Whelan, et al., 2005). As a result, as many as 25% of patients discontinue EBOT treatment in the first year (Patridge, Wang, Winter, & Avorn, 2003) despite evidence suggesting decreased recurrence (Cuzick, Sestak, Cella, & Fallowfield, 2008) and improved survival (Fink, Gurwitz, Rakowski, Guadagnoli & Silliman, 2004; Ruddy, Mayer, & Partridge, 2009). For women on EBOT, the management of symptoms related to treatment is one they are expected to independently handle with minimal follow up from health care providers (Winters, Habin, & Gallagher, 2007). This creates an added challenge to the survivorship experience of these women that the current survivorship models of care do not address. To date there are no nursing studies in the literature that address this transition experience of women on EBOT. Thus, a first step in addressing the gap in survivorship care related to women on EBOT is to describe the experience from the perspective of these women who live daily with the reality of breast cancer while receiving EBOT. Methods: This study will use a qualitative design, specifically the hermeneutic phenomenological (HP) design of Van Manen (1990) to describe the transition to EBOT experience of women with estrogen receptor positive breast cancer during the first year of treatment. This study will employ purposive maximum variation sampling to meet the study aims focsed on understanding women’s transition experience to EBOT. Twenty patients with estrogen receptor positive breast cancer meeting the inclusion criteria listed below will be recruited for particpation in the study. The proposed number of participants for this study is based on other qualitative studies in the literature that have employed a maximum variation sampling. (Morse & Richards, 2002). Results: At this point data collection is ongoing, but we expect to have the data analyzed by February. Implications: Understanding how women transition to long term EBOT will provide information about their survivorship needs.

Purpose/Aims: The specific aims of this study are to: 1)Describe the transition to endocrine based oral therapy (EBOT) experience of women with estrogen receptor positive breast cancer. 2) Identify what women transitioning to EBOT describe as unmet needs requiring intervention to improve the transition experience. 3) Determine what women transitioning to EBOT describe as facilitating and hindering the transition experience over the first several months of treatment. Background: Eighty per cent of breast cancers in women over 45 years of age are estrogen receptor positive cancers (Glass, Lacey, Carreon, & Hoover, 2007). At the end of what is typically a yearlong, aggressive treatment period, these women are expected to initiate 5-10 more years of ongoing treatment with endocrine-based oral chemotherapy (EBOT). Evidence from clinical trials aimed at reducing recurrence and improving life expectancy suggests that women on EBOT experience many distressing symptoms (Fellowes, Fallowfield, & Saunders, & Houghton, 2001; Fallowfield, et al., 2004; Tchen, et al., 2003; Whelan, et al., 2005). As a result, as many as 25% of patients discontinue EBOT treatment in the first year (Patridge, Wang, Winter, & Avorn, 2003) despite evidence suggesting decreased recurrence (Cuzick, Sestak, Cella, & Fallowfield, 2008) and improved survival (Fink, Gurwitz, Rakowski, Guadagnoli & Silliman, 2004; Ruddy, Mayer, & Partridge, 2009). For women on EBOT, the management of symptoms related to treatment is one they are expected to independently handle with minimal follow up from health care providers (Winters, Habin, & Gallagher, 2007). This creates an added challenge to the survivorship experience of these women that the current survivorship models of care do not address. To date there are no nursing studies in the literature that address this transition experience of women on EBOT. Thus, a first step in addressing the gap in survivorship care related to women on EBOT is to describe the experience from the perspective of these women who live daily with the reality of breast cancer while receiving EBOT. Methods: This study will use a qualitative design, specifically the hermeneutic phenomenological (HP) design of Van Manen (1990) to describe the transition to EBOT experience of women with estrogen receptor positive breast cancer during the first year of treatment. This study will employ purposive maximum variation sampling to meet the study aims focsed on understanding women’s transition experience to EBOT. Twenty patients with estrogen receptor positive breast cancer meeting the inclusion criteria listed below will be recruited for particpation in the study. The proposed number of participants for this study is based on other qualitative studies in the literature that have employed a maximum variation sampling. (Morse & Richards, 2002). Results: At this point data collection is ongoing, but we expect to have the data analyzed by February. Implications: Understanding how women transition to long term EBOT will provide information about their survivorship needs.

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dc.subject

Breast cancer

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dc.subject

Estrogen receptor positive

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dc.subject

Endocrine based oral therapy

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dc.date.available

2012-02-20T12:05:59Z

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dc.date.issued

2012-02-20T12:05:59Z

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dc.date.accessioned

2012-02-20T12:05:59Z

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dc.description.sponsorship

Western Institute of Nursing

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